ASCP STUDY GUIDE FOR MLT EXAM Questions and Answers Update 2026/2027

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ASCP STUDY

GUIDE FOR MLT

EXAM QUESTIONS

AND ANSWERS

Question 1: Which of the following laboratory results would be seen in a patient with acute Disseminated Intravascular Coagulation (DIC)?

Choices:

• prolonged PT, elevated platelet count, decreased FDP
• normal PT, decreased fibrinogen, decreased platelet count, decreased FDP
• prolonged PT, decreased fibrinogen, decreased platelet count, increased FDP
• normal PT, decreased platelet count, decreased FDP

Correct Answer: C; In DIC, or disseminated intravascular coagulation, the prothrombin time is increased due to the consumption of the coagulation factors due to the tiny clots forming throughout the vasculature. This is also the reason that the fibrinogen levels and platelet levels are decreased. Finally FDP, or fibrin degredation products, are increased due to the formation and subsequent dissolving of many tiny clots in the vasculature. The FDPs are the pieces of fibrin that are left after the fibrinolytic processes take place.

Question 2: A dilution commonly used for a routine sperm count is:

Choices:

A. 1:2

B. 1:20

C. 1:200

D. 1:400

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Correct Answer: B; A dilution commonly used for a routine sperm count is a 1:20.

Question 3: The prozone effect (when performing a screening titer) is most likely to result in:

Choices:

• False positive
• False negative
• No reaction at all
• Mixed field reaction

Correct Answer: B; Prozone effect (due to antibody excess) will result in an initial false negative in spite of the large amount of antibody in the serum, followed by a positive result as the specimen is diluted.

Question 4: Illust in this photograph is an agar quadrant plate containing casein (A), tyrosine (B), nitrate (C) and xanthine (D). None of the substrates have been hydrolyzed and

nitrate has been reduced. The most likely identification is:

Choices:

• Nocardia asteroides
• Nocardia brasiliensis
• Streptomyces griseus
• Actinomadura madurae

Correct Answer: A; One of the key characteristics to the identification of Nocardia asteroides is its inability to hydrolyze casein, tyrosine or xanthine. Nitrates are reduced to nitrites. Both Nocardia brasiliensis and Actinomadura madurae hydrolyze both casein and tyrosine; Streptomyces griseus hydrolyzes all three of the substrates.

Question 5: On an electronic cell counter, hemoglobin determination may be falsely elevated

caused by the presence of:

Choices:

• Lipemic or icteric plasma
• Leukocytopenia or Leukocytosis
• Rouleaux or agglutinated RBCs
• Anemia or Polycythemia

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Correct Answer: A; Since hemoglobin is measured spectrophotometrically on hematology analzyers, interference from lipemia or icteric specimens can lead to decreased light detected and measured through the sample and therefore inaccurate hemoglobin results occur.

Question 6: A patient who has a primarily vegetarian diet will most likely have an acid urine pH.

Choices:

• True
• False
• Only if accompanied by high citrus intake
• Only if accompanied by a low-carbohydrate diet

Correct Answer: False; A patient who has a primarily vegetarian diet will most likely have an alkaline urine pH. A low-carbohydrate diet as well as the ingestion of citrus fruits can also lead to a more alkaline urine sample.

Question 7: Serum TSH levels five-times the upper limit of normal in the presence of a low

T4 and low T3 uptake could mean which of the following:

Choices:

• The thyroid has been established as the cause of hypothyroidism
• The thyroid is ruled-out as the cause of hypothyroidism
• The pituitary has been established as the cause of hypothyroidism
• The diagnosis is consistent with secondary hyperthyroidism

Correct Answer: A; During primary hypothyroidism, where a defect in the thryoid gland is producing low levels of T3 and T4, the TSH level is increased. TSH is released in elevated quantities in an attempt to stimulate the thryoid to produce more T3 and T4 as part of a feedback mechanism.

Question 8: Which of the following species or organisms is the most likely to be the cause of mycotic keratitis (fungal eye infection)?

Choices:

• Fusarium species
• Trichophyton rubrum.

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• Scedosporium apiospermum
• Aspergillus niger

Correct Answer: A; Fusarium species is the most likely associated with mycotic keratitis.Trichophyton rubrum is a dermatophyte that commonly causes tinea pedis. Scedosporium apiospermum is commonly associated with sinusitis. Aspergillus niger typically causes otitis externa and can also be associated with sinusitis.

Question 9: Which of the following blood additives is most useful for serum collection:

Choices:

• Polymer barrier
• Oxalate

C. EDTA

• Citrate

Correct Answer: A; Oxalate, EDTA, and citrate are anticoagulants that inhibit clot formation.

Question 10: The laboratorian completed the mixing study ordered for John Doe. The results are as follows: Initial aPTT result: 167 seconds. Initial 1:1 Mix with Normal Pooled Plasma: 158 seconds. Incubated 1:1 Mix with Normal Pooled Plasma: 150 seconds. Which of the choices below would most likely explain the results for this patient?

Choices:

• Factor VIII deficiency
• Immediate-acting coagulation inhibitor
• Time/temperature-dependent coagulation inhibitor
• Factor VII deficiency

Correct Answer: B; This patient is most likely suffering from an immediate-acting coagulation inhibitor; most commonly, lupus anticoagulant. Notice that the addition of normal pooled plasma does not correct upon initial or incubated mix, which means that the inhibitor is not time or temperature-dependent.

Question 11: Given the following results, what is the immune status of the patient? HbsAg: positive, HbeAg: positive, Anti-HBc IgM: positive, Anti-HBs: negative

Choices: